Pub Date : 2026-01-01DOI: 10.1016/j.wfumbo.2025.100102
Shatha Jamal Almushayt
{"title":"Comment on: “Uterine contrast-enhanced ultrasound (CEUS): new insights into adenomyosis using an innovative technique”","authors":"Shatha Jamal Almushayt","doi":"10.1016/j.wfumbo.2025.100102","DOIUrl":"10.1016/j.wfumbo.2025.100102","url":null,"abstract":"","PeriodicalId":101281,"journal":{"name":"WFUMB Ultrasound Open","volume":"4 1","pages":"Article 100102"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-05DOI: 10.1016/j.wfumbo.2025.100100
Teng Zhang , Yongzhen Jin , Ruixiang Yu , Yuanyuan Li , Hao Wu
With rapid advances in ultrasonic technologies, cavitation has emerged as a versatile tool in medicine. Its intense mechanical and chemical effects have been leveraged for biomedical material processing, drug extraction, sterilization, cellular modulation, and targeted drug delivery. This review systematically summarizes recent progress in these applications and highlights cavitation-based clinical strategies, including sonodynamic therapy, tissue fragmentation, and light-mediated ultrasound therapy. While challenges remain-such as incomplete mechanistic understanding and lack of standardized parameters-ultrasonic cavitation holds promise as a controllable, efficient, and environmentally sustainable biophysical modality with significant potential for clinical translation.
{"title":"Ultrasonic cavitation in medicine: Current status and applications","authors":"Teng Zhang , Yongzhen Jin , Ruixiang Yu , Yuanyuan Li , Hao Wu","doi":"10.1016/j.wfumbo.2025.100100","DOIUrl":"10.1016/j.wfumbo.2025.100100","url":null,"abstract":"<div><div>With rapid advances in ultrasonic technologies, cavitation has emerged as a versatile tool in medicine. Its intense mechanical and chemical effects have been leveraged for biomedical material processing, drug extraction, sterilization, cellular modulation, and targeted drug delivery. This review systematically summarizes recent progress in these applications and highlights cavitation-based clinical strategies, including sonodynamic therapy, tissue fragmentation, and light-mediated ultrasound therapy. While challenges remain-such as incomplete mechanistic understanding and lack of standardized parameters-ultrasonic cavitation holds promise as a controllable, efficient, and environmentally sustainable biophysical modality with significant potential for clinical translation.</div></div>","PeriodicalId":101281,"journal":{"name":"WFUMB Ultrasound Open","volume":"4 1","pages":"Article 100100"},"PeriodicalIF":0.0,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-03DOI: 10.1016/j.wfumbo.2025.100099
Pascalle Wijntjes , Ferenc I. Kandi , Sophie Dassen , Luna Beijnsberger , Peiran Chen , Jingchao Sui , Myrthe van der Ven , Judith van Laar , Beatrijs van der Hout-van der Jagt , Simona Turco , Loes Monen , Massimo Mischi
Placental dysfunction contributed to many pregnancy complications, highlighting the need to clarify normal placental mechanisms and improve early detection. Contrast-enhanced ultrasound (CEUS) has demonstrated utility in visualizing the (micro)vasculature across other fields of medicine. However, its use in obstetrics for detailed visualization and characterization of the placental (micro)vasculature remains to be validated.
This pilot study explores the feasibility of CEUS for ex-vivo visualization of the fetal placenta, aiming to improve the understanding of feto-placental vascularization. It evaluates CEUS as a viable imaging method and its potential for quantifying vascular patterns in pregnancy complications, using advanced techniques like semi-quantitative CEUS and ultrasound localization microscopy (ULM) for detailed vascular assessments.
In this ex-vivo feasibility study, CEUS imaging of the fetal side of the placenta was performed by injecting an ultrasound contrast agent (UCA) in the umbilical vein. This allowed assessing the (micro)vascular perfusion using semi-quantitative CEUS, by analysis of the gray-level time evolution. In addition, ultrasound localization microscopy (ULM) was used to characterize the (micro)vascular architecture at high resolution.
Our finding demonstrate the feasibility of advances CEUS imaging approaches for both quantitative analysis and localization microscopy, providing high-resolution visualization and comprehensive characterization of the fetal side of the placental vasculature.
{"title":"Towards quantitative CEUS assessments of ex-vivo feto-placental (micro)vasculature: A feasibility study","authors":"Pascalle Wijntjes , Ferenc I. Kandi , Sophie Dassen , Luna Beijnsberger , Peiran Chen , Jingchao Sui , Myrthe van der Ven , Judith van Laar , Beatrijs van der Hout-van der Jagt , Simona Turco , Loes Monen , Massimo Mischi","doi":"10.1016/j.wfumbo.2025.100099","DOIUrl":"10.1016/j.wfumbo.2025.100099","url":null,"abstract":"<div><div>Placental dysfunction contributed to many pregnancy complications, highlighting the need to clarify normal placental mechanisms and improve early detection. Contrast-enhanced ultrasound (CEUS) has demonstrated utility in visualizing the (micro)vasculature across other fields of medicine. However, its use in obstetrics for detailed visualization and characterization of the placental (micro)vasculature remains to be validated.</div><div>This pilot study explores the feasibility of CEUS for ex-vivo visualization of the fetal placenta, aiming to improve the understanding of feto-placental vascularization. It evaluates CEUS as a viable imaging method and its potential for quantifying vascular patterns in pregnancy complications, using advanced techniques like semi-quantitative CEUS and ultrasound localization microscopy (ULM) for detailed vascular assessments.</div><div>In this ex-vivo feasibility study, CEUS imaging of the fetal side of the placenta was performed by injecting an ultrasound contrast agent (UCA) in the umbilical vein. This allowed assessing the (micro)vascular perfusion using semi-quantitative CEUS, by analysis of the gray-level time evolution. In addition, ultrasound localization microscopy (ULM) was used to characterize the (micro)vascular architecture at high resolution.</div><div>Our finding demonstrate the feasibility of advances CEUS imaging approaches for both quantitative analysis and localization microscopy, providing high-resolution visualization and comprehensive characterization of the fetal side of the placental vasculature.</div></div>","PeriodicalId":101281,"journal":{"name":"WFUMB Ultrasound Open","volume":"4 1","pages":"Article 100099"},"PeriodicalIF":0.0,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145750084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.wfumbo.2025.100086
{"title":"Erratum regarding missing IRB approval statement and the IRB registration number in previously published articles","authors":"","doi":"10.1016/j.wfumbo.2025.100086","DOIUrl":"10.1016/j.wfumbo.2025.100086","url":null,"abstract":"","PeriodicalId":101281,"journal":{"name":"WFUMB Ultrasound Open","volume":"3 2","pages":"Article 100086"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Metabolic dysfunction–associated steatotic liver disease (MASLD) is the most common pathology among all chronic liver diseases. In the early stages, steatotic liver disease (SLD) has an asymptomatic clinical course, which makes it difficult to detect. Ultrasound (US) is a safe, noninvasive, first-line method for SLD diagnosis, including determination of the hepatorenal index (HRI). The HRI is a convenient, semiquantitative, noninvasive method for SLD diagnostics. This case‒control observational study aimed to compare the diagnostic accuracy of conventional HRI and HRI with that of additional standardized acoustic depth assessments for SLD using MRI-PDFF as a reference.
Materials and methods
A total of 161 patients aged 18–67 years were examined. Patients >18 years of age were referred for MRI-PDFF assessment of suspected liver pathology. The only exclusion criterion was an absent or invalid HRI or MRI-PDFF.
Results
The quality of the HRI diagnostic model with a baseline (BL) was slightly higher, with an AUROC of 0.917 (p < 0.001), and the sensitivity and specificity were 83.0 % and 95.9 %, respectively. The AUROC for HRI without BL was 0.862 (p < 0.001) with sensitivity and specificity of 84.2 % and 85.1 %, respectively. Bland‒Altman analysis of the comparison of HRIs with and without BL revealed an error of 0.007 (p < 0.05).
Conclusions
Our study revealed that it is better to determine the semiquantitative HRI using a reference BL at a standardized uniform depth to preserve acoustic attenuation effects. The advantages of US SLD evaluation for HRI with BL are simplicity of performance and the accuracy of acoustic echogenicity measurements.
{"title":"Accuracy of the hepatorenal index with additional standardized acoustic depth assessment for steatotic liver disease diagnosis","authors":"Maksym Zhaivoronok , Oleg Dynnyk , Natalia Deresh , Ludovico Abenavoli , Nazarii Kobyliak","doi":"10.1016/j.wfumbo.2025.100083","DOIUrl":"10.1016/j.wfumbo.2025.100083","url":null,"abstract":"<div><div>Metabolic dysfunction–associated steatotic liver disease (MASLD) is the most common pathology among all chronic liver diseases. In the early stages, steatotic liver disease (SLD) has an asymptomatic clinical course, which makes it difficult to detect. Ultrasound (US) is a safe, noninvasive, first-line method for SLD diagnosis, including determination of the hepatorenal index (HRI). The HRI is a convenient, semiquantitative, noninvasive method for SLD diagnostics. This case‒control observational study aimed to compare the diagnostic accuracy of conventional HRI and HRI with that of additional standardized acoustic depth assessments for SLD using MRI-PDFF as a reference.</div></div><div><h3>Materials and methods</h3><div>A total of 161 patients aged 18–67 years were examined. Patients >18 years of age were referred for MRI-PDFF assessment of suspected liver pathology. The only exclusion criterion was an absent or invalid HRI or MRI-PDFF.</div></div><div><h3>Results</h3><div>The quality of the HRI diagnostic model with a baseline (BL) was slightly higher, with an AUROC of 0.917 (p < 0.001), and the sensitivity and specificity were 83.0 % and 95.9 %, respectively. The AUROC for HRI without BL was 0.862 (p < 0.001) with sensitivity and specificity of 84.2 % and 85.1 %, respectively. Bland‒Altman analysis of the comparison of HRIs with and without BL revealed an error of 0.007 (p < 0.05).</div></div><div><h3>Conclusions</h3><div>Our study revealed that it is better to determine the semiquantitative HRI using a reference BL at a standardized uniform depth to preserve acoustic attenuation effects. The advantages of US SLD evaluation for HRI with BL are simplicity of performance and the accuracy of acoustic echogenicity measurements.</div></div>","PeriodicalId":101281,"journal":{"name":"WFUMB Ultrasound Open","volume":"3 2","pages":"Article 100083"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-10DOI: 10.1016/j.wfumbo.2025.100097
Roberto Vega , Arun Nagdev , Masood Dehghan , Seyed Ehsan Seyed Bolouri , Brian Buchanan , Jeevesh Kapur , Jacob L. Jaremko , Dornoosh Zonoobi
Objective:
The left ventricular ejection fraction is a key metric for evaluating the systolic function in critically ill patients. Traditionally, it is computed using apical 2- and 4-chamber views in an echocardiogram; however, obtaining these views in an acutely ill patient in the emergency department is often difficult. A parasternal long-axis view, acquired with point of care ultrasound, is a faster and easier alternative. Unfortunately, the methods for estimating the ejection fraction from this view underperform when the left ventricular wall movement is not uniform or when its shape is not properly modeled as an ellipsoid. We propose a novel method that tracks the movement of the visible portions of the walls during the full cardiac cycle, and then estimates the ejection fraction based on that movement.
Methods:
We compared the performance of this method with the ejection fraction from the cardiology report on a dataset of 613 patients.
Results:
Our experiments showed an accuracy of 85% for identifying critically low values for ejection fraction (EF 30%) and 87% for abnormal ones (EF 50%). These values are comparable with the results obtained from the apical views and superior to current methods for the parasternal long-axis view.
Conclusion:
Since our method is fully automated, we expect that it can be adopted at scale in real-world clinical scenarios, giving practitioners a new tool to properly estimate the ejection fraction in clinically challenging scenarios.
{"title":"A wall tracking method to estimate ejection fraction from the parasternal long axis view in point of care ultrasound","authors":"Roberto Vega , Arun Nagdev , Masood Dehghan , Seyed Ehsan Seyed Bolouri , Brian Buchanan , Jeevesh Kapur , Jacob L. Jaremko , Dornoosh Zonoobi","doi":"10.1016/j.wfumbo.2025.100097","DOIUrl":"10.1016/j.wfumbo.2025.100097","url":null,"abstract":"<div><h3>Objective:</h3><div>The left ventricular ejection fraction is a key metric for evaluating the systolic function in critically ill patients. Traditionally, it is computed using apical 2- and 4-chamber views in an echocardiogram; however, obtaining these views in an acutely ill patient in the emergency department is often difficult. A parasternal long-axis view, acquired with point of care ultrasound, is a faster and easier alternative. Unfortunately, the methods for estimating the ejection fraction from this view underperform when the left ventricular wall movement is not uniform or when its shape is not properly modeled as an ellipsoid. We propose a novel method that tracks the movement of the visible portions of the walls during the full cardiac cycle, and then estimates the ejection fraction based on that movement.</div></div><div><h3>Methods:</h3><div>We compared the performance of this method with the ejection fraction from the cardiology report on a dataset of 613 patients.</div></div><div><h3>Results:</h3><div>Our experiments showed an accuracy of 85% for identifying critically low values for ejection fraction (EF <span><math><mo><</mo></math></span> 30%) and 87% for abnormal ones (EF <span><math><mo><</mo></math></span> 50%). These values are comparable with the results obtained from the apical views and superior to current methods for the parasternal long-axis view.</div></div><div><h3>Conclusion:</h3><div>Since our method is fully automated, we expect that it can be adopted at scale in real-world clinical scenarios, giving practitioners a new tool to properly estimate the ejection fraction in clinically challenging scenarios.</div></div>","PeriodicalId":101281,"journal":{"name":"WFUMB Ultrasound Open","volume":"3 2","pages":"Article 100097"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-08DOI: 10.1016/j.wfumbo.2025.100096
Ayiga Majid , Johnes Obungoloch , Alfred Enywaku , Obeti Francis , Denis Jjuuko , Eugene Bizimana , Biryomumeisho Joshua , Wasswa William
Congenital heart diseases (CHDs) are the commonest congenital anomalies and a leading cause of neonatal morbidity and mortality worldwide. They affect approximately 1 % of live births globally. Prenatal detection with fetal echocardiography allows for timely referral and intervention. However, screening performance remains uneven because of operator dependence and resource limits. Convolutional neural networks (CNNs) offer automated image interpretation and have been widely applied to 2D and 3D fetal ultrasound (US) in recent years.
This scoping review maps CNN applications for prenatal CHD across 2010–September 2025. In adherence to the PRISMA-ScR methodology, we screened 845 records from PubMed, IEEE Xplore, Google Scholar, ScienceDirect and preprint servers and included 29 studies for synthesis. The volume of articles published on the topic rose sharply after 2020, with most datasets drawn from Asia and North America and no representation from sub-Saharan Africa. The most commonly reported architectures were DenseNet variants, U-Net families for segmentation, YOLO (You Only Look Once) variants for real-time detection, and ensemble hybrids for classification.
Reported internal performance is high in many studies, with top models achieving near-expert discrimination with AUCs (Area Under the Curve) up to 0.99. In our cohort, the mean AUC across studies reporting that metric was 0.911 (Standard Deviation-SD = 0.09; 95 % CI: 0.86–0.96; n = 11). Average sensitivity and specificity across studies reporting these metrics were 0.92 (SD = 0.04; n = 13) and 0.91 (SD = 0.04; n = 7), respectively. However, external and multi-centre validation remains limited, and performance commonly falls when models are tested on unseen centers or different scanner types. Methodological gaps include small or imbalanced lesion classes, inconsistent patient-level splitting, sparse reporting of deployment constraints, and limited fairness analyses.
Recent work shows promising directions such as multimodal fusion of B-mode and Doppler, lightweight networks, on-device optimization, federated and privacy-preserving training, and prospective protocols for multi-centre evaluation. To translate CNNs into clinical screening, we recommend coordinated efforts to build diverse, well-annotated repositories, adopt strict patient-level validation and external testing, report deployment metrics, and run prospective, pragmatic trials that measure clinical outcomes and health-economic impact. These steps can move CNNs from high-performance demonstrations to dependable tools that improve prenatal CHD detection equitably.
先天性心脏病（CHDs）是最常见的先天性异常，也是全世界新生儿发病率和死亡率的主要原因。它们影响了全球约1%的活产。产前检测胎儿超声心动图允许及时转诊和干预。然而，由于操作者的依赖性和资源限制，筛选效果仍然参差不齐。卷积神经网络（cnn）提供自动图像解释，近年来已广泛应用于二维和三维胎儿超声（US）。这一范围综述绘制了2010年至2025年9月期间CNN在产前冠心病中的应用。按照PRISMA-ScR方法，我们从PubMed、IEEE explore、b谷歌Scholar、ScienceDirect和预印服务器中筛选了845条记录，并纳入了29项研究用于合成。在2020年之后，发表的关于该主题的文章数量急剧增加，大多数数据集来自亚洲和北美，没有来自撒哈拉以南非洲的代表。最常见的报告架构是DenseNet变体，用于分割的U-Net系列，用于实时检测的YOLO （You Only Look Once）变体，以及用于分类的集成混合。在许多研究中，报告的内部绩效很高，顶级模型的auc（曲线下面积）达到了0.99的接近专家的区分。在我们的队列中，报告度量的研究的平均AUC为0.911（标准差= 0.09;95% CI: 0.86-0.96; n = 11）。报告这些指标的研究的平均灵敏度和特异性分别为0.92 （SD = 0.04, n = 13）和0.91 （SD = 0.04, n = 7）。然而，外部和多中心验证仍然有限，并且当模型在未见过的中心或不同的扫描仪类型上进行测试时，性能通常会下降。方法上的差距包括小的或不平衡的病变类别、不一致的患者水平划分、部署约束的稀疏报告和有限的公平性分析。最近的工作显示了有希望的方向，如b模式和多普勒的多模态融合，轻量级网络，设备上优化，联合和隐私保护培训，以及多中心评估的前瞻性协议。为了将cnn转化为临床筛查，我们建议协调努力，建立多样化、注释良好的知识库，采用严格的患者级验证和外部测试，报告部署指标，并进行前瞻性、务实的试验，以衡量临床结果和健康经济影响。这些步骤可以将cnn从高性能演示转变为可靠的工具，从而公平地改善产前冠心病检测。
{"title":"Diagnosis of congenital heart diseases in children from 2D and 3D sonography using convolutional neural networks: A scoping literature review","authors":"Ayiga Majid , Johnes Obungoloch , Alfred Enywaku , Obeti Francis , Denis Jjuuko , Eugene Bizimana , Biryomumeisho Joshua , Wasswa William","doi":"10.1016/j.wfumbo.2025.100096","DOIUrl":"10.1016/j.wfumbo.2025.100096","url":null,"abstract":"<div><div>Congenital heart diseases (CHDs) are the commonest congenital anomalies and a leading cause of neonatal morbidity and mortality worldwide. They affect approximately 1 % of live births globally. Prenatal detection with fetal echocardiography allows for timely referral and intervention. However, screening performance remains uneven because of operator dependence and resource limits. Convolutional neural networks (CNNs) offer automated image interpretation and have been widely applied to 2D and 3D fetal ultrasound (US) in recent years.</div><div>This scoping review maps CNN applications for prenatal CHD across 2010–September 2025. In adherence to the PRISMA-ScR methodology, we screened 845 records from PubMed, IEEE Xplore, Google Scholar, ScienceDirect and preprint servers and included 29 studies for synthesis. The volume of articles published on the topic rose sharply after 2020, with most datasets drawn from Asia and North America and no representation from sub-Saharan Africa. The most commonly reported architectures were DenseNet variants, U-Net families for segmentation, YOLO (You Only Look Once) variants for real-time detection, and ensemble hybrids for classification.</div><div>Reported internal performance is high in many studies, with top models achieving near-expert discrimination with AUCs (Area Under the Curve) up to 0.99. In our cohort, the mean AUC across studies reporting that metric was 0.911 (Standard Deviation-SD = 0.09; 95 % CI: 0.86–0.96; n = 11). Average sensitivity and specificity across studies reporting these metrics were 0.92 (SD = 0.04; n = 13) and 0.91 (SD = 0.04; n = 7), respectively. However, external and multi-centre validation remains limited, and performance commonly falls when models are tested on unseen centers or different scanner types. Methodological gaps include small or imbalanced lesion classes, inconsistent patient-level splitting, sparse reporting of deployment constraints, and limited fairness analyses.</div><div>Recent work shows promising directions such as multimodal fusion of B-mode and Doppler, lightweight networks, on-device optimization, federated and privacy-preserving training, and prospective protocols for multi-centre evaluation. To translate CNNs into clinical screening, we recommend coordinated efforts to build diverse, well-annotated repositories, adopt strict patient-level validation and external testing, report deployment metrics, and run prospective, pragmatic trials that measure clinical outcomes and health-economic impact. These steps can move CNNs from high-performance demonstrations to dependable tools that improve prenatal CHD detection equitably.</div></div>","PeriodicalId":101281,"journal":{"name":"WFUMB Ultrasound Open","volume":"3 2","pages":"Article 100096"},"PeriodicalIF":0.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.wfumbo.2025.100095
Eva J.E. de Bock , Barbara Stoelinga , Jan Hein T.M. van Waesberghe , Ferenc I. Kandi , Catarina Dinis Fernandes , Massimo Mischi , Judith A.F. Huirne , Nicole B. Burger , Lynda J.M. Juffermans
Objectives
Heavy menstrual bleeding, dysmenorrhea and subfertility are associated with adenomyosis, a benign uterine condition characterised by ectopic endometrium within the myometrium. Currently, diagnosing adenomyosis is challenging. Imaging the uterine microcirculation using contrast-enhanced ultrasound (CEUS) may improve diagnostics. We aimed to 1) determine the feasibility of transvaginal two-dimensional (2D) uterine CEUS, 2) compare features of adenomyosis on 2D CEUS with conventional ultrasound and Magnetic Resonance Imaging (MRI), and 3) qualitatively and quantitatively analyse 2D CEUS scans of patients with adenomyosis.
Methods
We included ten pre-menopausal adult patients with prominent direct Morphological Uterus Sonographic Assessment (MUSA) features of adenomyosis on B-mode. MRI scans were collected when clinically available. Conventional ultrasound and a 3-min transvaginal 2D CEUS scan were performed and analysed. Uterine wash-in and wash-out of the contrast agent were analysed qualitatively, and quantitatively using time-intensity curve parameters.
Results
Performing transvaginal CEUS scans was feasible, providing good visualisation of uterine macro- and microcirculation. CEUS visualised smaller and deeper-lying blood vessels than Doppler ultrasound. In the myometrium, non-to hypo-enhanced areas interspersed with hyper-enhanced regions, and vessels with enlarged lumen were observed. Hyper-echoic islands on B-mode showed either hypo- or hyper-enhancement on CEUS. Qualitative analysis and time-intensity maps showed clear heterogeneous myometrial perfusion in all patients with adenomyosis.
Conclusions
Transvaginal CEUS is a feasible technique for qualitative and quantitative analysis of the uterine macro- and microcirculation. It holds promise as a diagnostic imaging modality for adenomyosis.
{"title":"Uterine contrast-enhanced ultrasound (CEUS): new insights into adenomyosis using an innovative technique","authors":"Eva J.E. de Bock , Barbara Stoelinga , Jan Hein T.M. van Waesberghe , Ferenc I. Kandi , Catarina Dinis Fernandes , Massimo Mischi , Judith A.F. Huirne , Nicole B. Burger , Lynda J.M. Juffermans","doi":"10.1016/j.wfumbo.2025.100095","DOIUrl":"10.1016/j.wfumbo.2025.100095","url":null,"abstract":"<div><h3>Objectives</h3><div>Heavy menstrual bleeding, dysmenorrhea and subfertility are associated with adenomyosis, a benign uterine condition characterised by ectopic endometrium within the myometrium. Currently, diagnosing adenomyosis is challenging. Imaging the uterine microcirculation using contrast-enhanced ultrasound (CEUS) may improve diagnostics. We aimed to 1) determine the feasibility of transvaginal two-dimensional (2D) uterine CEUS, 2) compare features of adenomyosis on 2D CEUS with conventional ultrasound and Magnetic Resonance Imaging (MRI), and 3) qualitatively and quantitatively analyse 2D CEUS scans of patients with adenomyosis.</div></div><div><h3>Methods</h3><div>We included ten pre-menopausal adult patients with prominent direct Morphological Uterus Sonographic Assessment (MUSA) features of adenomyosis on B-mode. MRI scans were collected when clinically available. Conventional ultrasound and a 3-min transvaginal 2D CEUS scan were performed and analysed. Uterine wash-in and wash-out of the contrast agent were analysed qualitatively, and quantitatively using time-intensity curve parameters.</div></div><div><h3>Results</h3><div>Performing transvaginal CEUS scans was feasible, providing good visualisation of uterine macro- and microcirculation. CEUS visualised smaller and deeper-lying blood vessels than Doppler ultrasound. In the myometrium, non-to hypo-enhanced areas interspersed with hyper-enhanced regions, and vessels with enlarged lumen were observed. Hyper-echoic islands on B-mode showed either hypo- or hyper-enhancement on CEUS. Qualitative analysis and time-intensity maps showed clear heterogeneous myometrial perfusion in all patients with adenomyosis.</div></div><div><h3>Conclusions</h3><div>Transvaginal CEUS is a feasible technique for qualitative and quantitative analysis of the uterine macro- and microcirculation. It holds promise as a diagnostic imaging modality for adenomyosis.</div></div>","PeriodicalId":101281,"journal":{"name":"WFUMB Ultrasound Open","volume":"3 2","pages":"Article 100095"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145360999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-30DOI: 10.1016/j.wfumbo.2025.100094
Balew Arega
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